Terminology forWell Child ServicesMapping Plunket Terms to SNOMED CT
Plunket Background• 1500 Paid Staff & 6000 Volunteers• 250,000 child clients on our database and over  700,000 contacts pe...
PlunketPlus Vision         Improved           Health        Outcomes for          Families   Free up         Work in   sta...
PlunketPlus Pillars Improved  Health       Integration OutcomesChild/Family               Service Led  Centred
Expected Outcomes                    Interoperable   Flexibility                                                  Access t...
Terminology   Interoperability   Comparability     Systematic      approachCurrent definitions•Well Child•Community•Popula...
Process                                                    Most useful                                                    ...
Mapping of SNOMED CT              • 930 componentsWell Child    • Majority mapped to SNOMED CT              • ?Omaha Class...
Plunket Data Entities                         Data Entity           Count of         Each of these                        ...
Data Items to Data ElementsEach Data Item    has one or      Data         Data                                            ...
The Mapping Process•   Using this hierarchy of Entity / Item /    Element the Element was compared to    Snomed CT to see ...
Examples of data items and                                                            data elements                       ...
What This Means•   Those Elements marked with an asterix in the    last column have no Snomed CT mapping.•   This means th...
Some Interesting non mapping                         Plunket Elements•   NBC date of Birth – Plunket New Baby case is a Pl...
Others•   Iwi•   Hapu•   Many „free text‟ descriptions•   Frequency in relation to Items
From the other direction•   The logical data configuration of PlunketPlus is designed to be    robust, powerful and flexib...
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Terminology for Well Child Services: Mapping Plunket terms to SNOMED CT

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Brenda Hynes
Royal New Zealand Plunket Society
(Friday, 2.30, Innovation in Practice 3)

The key vision for the new client information system for Plunket (PlunketPlus) is to improve the health outcomes of New Zealand families. One way this will be achieved is through PlunketPlus being interoperable with systems of other providers of services to the families. To enable interoperability and data sharing between systems, and to allow comparability, and consistent interpretation of information it is important that PlunketPlus uses a terminology standard that can be understood directly by other systems or mapped to terminologies of other systems. This paper describes the process that Plunket has followed regarding the selection of the terminology to be used in PlunketPlus.

Published in: Health & Medicine
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Terminology for Well Child Services: Mapping Plunket terms to SNOMED CT

  1. 1. Terminology forWell Child ServicesMapping Plunket Terms to SNOMED CT
  2. 2. Plunket Background• 1500 Paid Staff & 6000 Volunteers• 250,000 child clients on our database and over 700,000 contacts per year• Variety of Service• Current Systems – POND, PlunketLine, CSRS, Individual Databases, Paper records• Communication with other professionals via faxes and handwritten referrals
  3. 3. PlunketPlus Vision Improved Health Outcomes for Families Free up Work in staff to partnership allow more withtime to care Parents
  4. 4. PlunketPlus Pillars Improved Health Integration OutcomesChild/Family Service Led Centred
  5. 5. Expected Outcomes Interoperable Flexibility Access the Easy to use records of every child Improved One clientoutcomes for Outcomes record across families Plunket
  6. 6. Terminology Interoperability Comparability Systematic approachCurrent definitions•Well Child•Community•Population Information
  7. 7. Process Most useful and usable No Matches Bespoke Matches – Indepth analysis Analysis – Nursing Terminology & SNOMEDRefine – CTDataDictionary
  8. 8. Mapping of SNOMED CT • 930 componentsWell Child • Majority mapped to SNOMED CT • ?Omaha Classification SystemDictionary • Parenting Education Other • Community Support Services • PPNAPdefinitions • Antenatal Education • Breastfeeding Support Services
  9. 9. Plunket Data Entities Data Entity Count of Each of these Data Items entities has aPlunket has identified number of data Caregiver Client 258 data entities in its items thatdata dictionary which Child Client 28 define /was heavily influenced Client Contact 66 describe theby our current system. entity. The the Family Data 31This may not prove to counts of databe the best way to map Health History 22 items in relationto Snomed CT in the Maternal Health 16 to each entity isend but it gave us a listed. Paternal Health 7starting point. Physical Assessment 25 In PlunketPlus the data dictionary will expand and develop to suit the needs of best practice.
  10. 10. Data Items to Data ElementsEach Data Item has one or Data Data Data Elements more Data Entities Items Elements Free text description that make Reference Table 1 – Education purpose (need) up the Data Reference Table 2 – Education Type Item. Reference Table 3 – Education recipient This example Health education Reference Table 4 – information given (per shows the 6 education type and recipient) Data Elements Reference Table 5 – change in behaviour that make up Client evidenced (per education type and recipient) Contact Health And 65 Education Others And 314 distributed over the 65 Items Data Item.
  11. 11. The Mapping Process• Using this hierarchy of Entity / Item / Element the Element was compared to Snomed CT to see if a match existed.• An Excel table was produced to show the mapping of 930 Elements. An exert, to show the mapping for Client Contact / Health Education is on the next slide.
  12. 12. Examples of data items and data elements Potential Data Elements That Make up Data Items Data element Purpose / Snomed CT Mapping (as reference in Plunket additional Classification of Purpose / Definition of (examples only notEntity Data Items Description) description Data Element Data Element Type Format exhaustive) Document specificClient Health Intervention details of health FreeContact education Free text Free Text Target education Free text text * EducationClient Health Reference Table 1 – Intervention Intervention Distinguish reason for Reference Drop (procedure)Contact education Education purpose (need) Type Target providing intervention Table Down [409073007 Distinguish components Intervention regimesClient Health Reference Table 2 – Intervention Intervention and type of education Reference Drop (regime/therapy)Contact education Education Type Type Category achieved Table Down [225334002]Client Health Reference Table 3 – Distinguish recipient of Reference DropContact education Education recipient Name Identification intervention received Table Down * Reference Table 4 – information given (per Distinguish components Intervention regimesClient Health education type and Intervention Intervention and type of education Reference Drop (regime/therapy)Contact education recipient) Type Target achieved Table Down [225334002] Reference Table 5 – change in behaviour evidenced (per Distinguish level of skills Change in behaviorClient Health education type and demonstrated in Reference Drop (observable entity)Contact education recipient) (blank) Outcome Rating education Table Down [315244000]
  13. 13. What This Means• Those Elements marked with an asterix in the last column have no Snomed CT mapping.• This means that external systems will not be able to send to Plunket and Plunket will not be able to send details as to the caregiver receiving the education and text description.• Most elements do have a mapping. This example was chosen to show elements that do not have a mapping.
  14. 14. Some Interesting non mapping Plunket Elements• NBC date of Birth – Plunket New Baby case is a Plunket term. Client date of birth is mapped. This element will not be needed by most other users of Snomed CT as it is a “Well Child/Tamariki Ora” Term.• Adults other than the caregiver attending a contact. This is probably not an important element for our external partners and probably does not need a Snomed CT element to map to.
  15. 15. Others• Iwi• Hapu• Many „free text‟ descriptions• Frequency in relation to Items
  16. 16. From the other direction• The logical data configuration of PlunketPlus is designed to be robust, powerful and flexible.• The data dictionary will influence the way in which PlunketPlus is configured and Plunket will ensure that, initially, PlunketPlus can reflect /reproduce the data dictionary. This does not have to dictate how we map to Snomed CT.• PlunketPlus will allow the data dictionary to develop and evolve to support the needs of best practice.• If new elements are needed to map to Snomed CT then this will be possible.• If Plunket identifies an element it believes needs to be added to Snomed CT we would follow the process set out by the Health IT Board to get it added.

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